First off, thanks so much for taking time to read through my lengthy post. So...a persistent and continuous twitch between the thumb and index finger on the right brought me to the GP (I am 37 years old) - that specific twich stopped after 2 weeks. Very frequent (as in several per minute) twitches elsewhere (legs, hands, including moving fingers). At the time of the GP visit, I did not feel weakness, but (as I found out from the neuro later), his strength tests found weakness in the right hand - in the muscle that moves the pinky finger outward. I also have brisk reflexes. The GP did blood tests (all normal), and referred me to a neuro. At the neuro, a resident in her last year did all the neurological/strength testing, the doc just came in at the end. He agreed to do an NC/EMG the next day.
Before I bring up my concerns, let me say that this neuro is a general neuro (not neuromuscular), but he is board certified in Clinical Neurophysiology and Electrodiagnostic Medicine. He does EMGs in his office one afternoon a week, and does teach a fellowship student (post residency) in electrodiagnostic medicine.
This was my first EMG - so maybe I am worried about nothing...Btw, there was lots of talking and laughter during the exam.
The EMG part itself did not take all that long. All told, I was in there for about 1 hour 15 minutes total, the nerve conduction tests look longer than the EMG. He tested 5 muscles in the right arm, and 5 in the right leg.
1) The muscle that had been identified as weak in the exam was the one muscle where there were movements on the screen while I was supposed to be at rest. After pushing against the finger a couple of times, the neuro declared that was voluntary movement (I have since read up on this, and it seems that is normal procedure). However, I don't think he ever really observed that muscle at rest after that, or at least he did so for only a second or two).
2) He did not test the muscle that had had 2 weeks of continuous twitching - only 2 nearby muscles. (He claimed when asked that there were only a few spots to put needles in, but I don't think that's true)
2) The neuro inserted one needle per muscle, and at rest really did not look at the screen for very long. Maybe 10-15 seconds at the very most? Of course, I didn't time it, but it didn't feel very long (I read on this site that someone actually didn't get diagnosed on EMG until a neuro took longer to observe the muscles at rest - hence my concern).
3) The tibialis anterior had a fascis, no others found during the EMG. This is not really a concern...
4) When I was told to tighten my leg (calf muscle?), I cramped. Same with with another leg muscle (cramping was starting in the foot pretty much as soon as I had to tighten the muscles). So for 2 of the 5 leg muscles (the 2 with needles from the side/back), I cramped. Is this worrisome? I have found nothing regarding the significance of cramping during EMGs.
According to the neuro, there was no cause for the weakness in the pinky found. Since the twitching started about a month ago, my right ankle and knee and right wrist have been slightly achy and sore/fatigued, and subjectively weak. But that could be a coincidence, as I do carry my 17+ lb baby on that side up and down the stairs. I had the EMG about 2.5 weeks after the start of twiching, and about half a week after the onset of soreness/fatigue. Can I breathe a sigh of relief and forget about all of this, despite the clinical weakness, perceived weakness on the right side, and brisk reflexes, or should I insist on a second opinion? In short, can I trust this EMG?
Before I bring up my concerns, let me say that this neuro is a general neuro (not neuromuscular), but he is board certified in Clinical Neurophysiology and Electrodiagnostic Medicine. He does EMGs in his office one afternoon a week, and does teach a fellowship student (post residency) in electrodiagnostic medicine.
This was my first EMG - so maybe I am worried about nothing...Btw, there was lots of talking and laughter during the exam.
The EMG part itself did not take all that long. All told, I was in there for about 1 hour 15 minutes total, the nerve conduction tests look longer than the EMG. He tested 5 muscles in the right arm, and 5 in the right leg.
1) The muscle that had been identified as weak in the exam was the one muscle where there were movements on the screen while I was supposed to be at rest. After pushing against the finger a couple of times, the neuro declared that was voluntary movement (I have since read up on this, and it seems that is normal procedure). However, I don't think he ever really observed that muscle at rest after that, or at least he did so for only a second or two).
2) He did not test the muscle that had had 2 weeks of continuous twitching - only 2 nearby muscles. (He claimed when asked that there were only a few spots to put needles in, but I don't think that's true)
2) The neuro inserted one needle per muscle, and at rest really did not look at the screen for very long. Maybe 10-15 seconds at the very most? Of course, I didn't time it, but it didn't feel very long (I read on this site that someone actually didn't get diagnosed on EMG until a neuro took longer to observe the muscles at rest - hence my concern).
3) The tibialis anterior had a fascis, no others found during the EMG. This is not really a concern...
4) When I was told to tighten my leg (calf muscle?), I cramped. Same with with another leg muscle (cramping was starting in the foot pretty much as soon as I had to tighten the muscles). So for 2 of the 5 leg muscles (the 2 with needles from the side/back), I cramped. Is this worrisome? I have found nothing regarding the significance of cramping during EMGs.
According to the neuro, there was no cause for the weakness in the pinky found. Since the twitching started about a month ago, my right ankle and knee and right wrist have been slightly achy and sore/fatigued, and subjectively weak. But that could be a coincidence, as I do carry my 17+ lb baby on that side up and down the stairs. I had the EMG about 2.5 weeks after the start of twiching, and about half a week after the onset of soreness/fatigue. Can I breathe a sigh of relief and forget about all of this, despite the clinical weakness, perceived weakness on the right side, and brisk reflexes, or should I insist on a second opinion? In short, can I trust this EMG?